Temporal pathways from attachment insecurity to paranoia in a heterogeneous clinical sample: An experience sampling study.

INTRODUCTION: There has been growing interest in the role of attachment mechanisms in the onset and maintenance of paranoia. The latest systematic reviews of mixed samples of healthy individuals and psychiatric patients have revealed that increased trait attachment anxiety and avoidance are associated with experiencing paranoia, with trait attachment anxiety showing a stronger association. Few studies have examined attachment and paranoia in naturalistic conditions via the Experience Sampling Method. OBJECTIVES: The present study examined whether experiences of attachment anxiety and avoidance fluctuate in the flow of daily life, and whether a within-person change in both attachment states precedes the experience of momentary paranoia, and negative and positive emotions. METHODS: Thirty-seven clinical participants and twenty-six healthy controls were studied over six consecutive days using the Experience Sampling Method (ESM). An experience-in-close-relationships questionnaire (ECR-R 16 SF) was used to capture trait attachment dimensions. Several ESM items were used to capture momentary negative and positive affect, paranoia and attachment insecurity states. RESULTS: The findings revealed that fluctuations in both attachment insecurity states were significantly higher in the clinical group. A prior elevated attachment anxiety and avoidance was followed by an increase in negative affect in the next moment and elevated attachment avoidance was additionally followed by a decrease in positive affect and an increase in paranoia. CONCLUSION: Our findings reveal the specific temporal associations between momentary attachment insecurity states as predictors of change in emotions/affects and paranoia, along with evidence that state attachment avoidance has a superior impact on momentary affect and paranoia compared to state attachment anxiety. These results contrast with those of recent cross-sectional studies.

Transmission of parental childhood trauma to child behavior problems: Parental Hostile/Helpless state of mind as a moderator.

BACKGROUND: Little attention has been given to intergenerational transmission of risk, mainly whether caregivers' history of childhood maltreatment is linked to behavioral symptoms in their children and which protective/risk factors are involved in this transmission process. OBJECTIVE: This study examined if parental Hostile/Helpless (H/H) state of mind with respect to attachment moderated the association between parental childhood trauma and behavior problems in maltreated children. PARTICIPANTS AND SETTING: The sample included 61 parents and their children victims or at very high risk of maltreatment, aged between 1 and 6 years old. METHOD: Parents retrospectively reported their childhood trauma and completed a measure of their children's behavior problems. Independent observers assessed H/H attachment representations. RESULTS: Among parents with H/H states of mind, more severe traumatic childhood experiences were associated with more externalizing and internalizing behavior problems in their children. Among non-H/H parents, associations between parental childhood trauma and child behavior problems were not significant. CONCLUSIONS: In the context of trauma, this study suggests that the absence of a H/H state of mind in parents (i.e., the presence of an organized attachment state of mind) is a protective factor for child adjustment. H/H mental representations of self and attachment experiences as targets of intervention for parents with histories of maltreatment may help reduce the transmission of risk in maltreating families.

Antecedents of attachment states of mind in normative-risk and high-risk caregiving: cross-race and cross-sex generalizability in two longitudinal studies.

BACKGROUND: Longitudinal investigations of relatively large typical-risk (e.g., Booth-LaForce & Roisman, 2014) and higher-risk samples (e.g., Raby et al., 2017; Roisman et al., 2017) have produced evidence consistent with the claim that attachment states of mind in adolescence and young adulthood, as measured by the Adult Attachment Interview (AAI), are associated with the quality of caregiving experienced during childhood. None of these studies, however, has examined whether such associations are consistent across sex and/or race, as would be expected in light of the sensitivity hypothesis of attachment theory. METHODS: We examine whether sex or race moderates previously reported links between caregiving and AAI states of mind in two longitudinal studies (pooled N = 1,058) in which caregiving was measured either within (i.e., observed [in]sensitive care) or outside (i.e., childhood maltreatment) of the normative range of caregiving experiences. RESULTS: Hierarchical moderated regression analyses in both longitudinal cohorts provided evidence that maternal insensitivity and experiences of maltreatment were prospectively associated with dismissing and preoccupied states of mind in adolescence, as hypothesized. Moreover, these associations were generally comparable in magnitude for African American and White/non-Hispanic participants and were not conditional on participants' biological sex. CONCLUSIONS: Both maternal insensitivity and the experience of maltreatment increased risk for insecure attachment states of mind in adolescence. Moreover, our analyses provided little evidence that either participant race or participant sex assigned at birth moderated these nontrivial associations between measures of the quality of experienced caregiving and insecure attachment states of mind in adolescence. These findings provide support for the sensitivity hypothesis of attachment theory and inform the cultural universality hypothesis of attachment processes.

Childhood abuse and neglect, attachment states of mind, and non-suicidal self-injury.

This investigation examined preoccupied attachment states of mind as both a risk factor for non-suicidal self-injury (NSSI) and as a mechanism by which prospectively assessed childhood experiences of abuse and neglect predicted the frequency/severity of NSSI behavior up to age 26 years in 164 individuals (83 females) who were followed from birth in the Minnesota Longitudinal Study of Risk and Adaptation. Preoccupied (but not dismissing) states of mind regarding both childhood caregivers and adult romantic partners were correlated with more frequent/severe NSSI. Furthermore, preoccupied states of mind regarding caregivers partially accounted for the association between childhood abuse/neglect and NSSI. This work represents a rare prospective test of a developmental psychopathology framework for understanding NSSI behavior, in which atypical caregiving experiences are carried forward through attachment representations of caregivers that reflect behavioral risk.

When parenting fails: alexithymia and attachment states of mind in mothers of female patients with eating disorders.

INTRODUCTION: In recent years alexithymia and attachment theory have been recognized as two parallel research lines trying to improve the information on the development and maintenance of eating disorders (EDs). However, no research has analyzed these constructs among patients' families. In this study we compared alexithymia and attachment in mothers of patients with EDs and a control group. Further, we hypothesized that mothers of daughters with EDs with insecure and unresolved states of mind will reported high levels of alexithymia. Lastly, we explored the daughters' evaluations of maternal alexithymia. METHODS: 45 mothers of ED women and 48 mothers of healthy controls (N = 93) matched for age and socio-demographic variables were administered by the Toronto Alexithymia Scale-20 (TAS-20) (S), while two sub-groups of "ED" mothers (n = 20) and "non-ED" ones (n = 22) were assessed by the Adult Attachment Interview (AAI). Moreover, the Observer Alexithymia Scale (OAS) was administered to the daughters for evaluating maternal alexithymia. RESULTS: Regarding alexithymia, no differences were found between ED and non-ED mothers according to the TAS-20, while ED mothers showed more unresolved AAI classifications than non-ED mothers. No correlations were found between the TAS-20 and the AAI. Lastly, ED mothers were evaluated more alexithymic by their daughters with the OAS than those in the control group, and their alexithymic traits were significantly correlated with dismissing states of mind (idealization and lack of memory) in the AAIs. DISCUSSION: Our results highlighted an interesting discrepancy among mothers with ED daughters between the low level of alexithymia provided by their self-reports and the high level of alexithymia observed by their daughters, although the OAS showed severe methodological limitations. Maternal attachment states of mind characterized by the lack of resolution of past losses could be connected to a confusing and incoherent quality of parenting.